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 Peddlers or Solicitors License
CITY OF BUCHANAN DATE:__________________ No.______________ COMPANY NAME:______________________________________________________ COMPANY ADDRESS:___________________________________________________ DBA:__________________________________________________________________ NAME AND PERMANENT ADDRESS OF ALL PERSONNEL WORKING UNDER THIS PERMIT: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ SOLICITOR PEDDLER CHARITABLE SOLICITOR FEE:_________________ TYPE OF OPERATION:________________________________________________ DATE OF OPERATION:_________________TERMINATION:________________ APPLICANT NAME:__________________________________________________ APPLICANT ADDRESS:_______________________________________________ TELEPHONE:________________________________________________________ DRIVERS LICENSE:______________________________________Copy Attached VEHICLE DESCRIPTION:_____________________________________________ Police Chief: Approval Disapproval Reason for Disapproval:________________________________________________ (Seal)
__________________________ ___________________________ Chief of Police City Clerk 302 N. Redbud Trail 49107 Phone #269-695-3844 Fax# 269-695-4330
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